Do members need a referral from their Primary Care Physician?

Members never need a referral from their PCP, but Quest does encourage ongoing communication between behavioral healthcare providers and the member’s PCP to facilitate coordination of care.

How do I determine a member’s benefits?

Providers may request membership eligibility and benefits online using our Member Eligibility and Benefits Request form or call Quest at 800-364-6352.

How do I submit a claim?

All network providers should submit claims on the appropriate form (1500 form for outpatient and UB form for all higher levels of care). Forms may be submitted via a secured email to claims@questbh.com, via fax to 717-851-1414, or by mail to Quest at P.O. Box 1032, York, PA 17405

What if Quest is the secondary insurance?

If Quest is the secondary insurance for a member, providers are required to stay within the boundaries of the primary insurer. Quest requires an EOB (Explanation of Benefits) from the primary insurance to process claims.

What if I have questions regarding a claim?

You may submit questions regarding claim status online with our Claim Status Inquiry form, by sending a secure email to our Claims Center at claims@questbh.com, or by calling Quest at 800-364-6352.